The Dutchman hit the deck when several riders crashed at a roundabout with 6km to go on stage 4, suffering a wound to his knee that looked to have been caused by a chainring.
He crossed the finish line more than four minutes behind the stage winner Richard Carapaz and race leader Primoz Roglic, and declared his GC challenge over. As he limped onto his team bus, his very presence in the race hung in the balance through to Wednesday morning, but Team Sunweb confirmed that he would indeed start the stage. Whether he finishes it is another matter.
“Medically speaking he is cleared to race, but the day’s eventuality is dependent on how much pain his knee brings,” said Team Sunweb physician Stephan Jacolino.
“Hopefully it goes well and the pain subsides as the day goes on.”
Dumoulin declared his chances of winning a second Giro d’Italia title over on Tuesday evening, saying he would “sleep on it” before deciding whether to continue in the race.
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His left leg was covered in blood from the wound and the way he finished the stage and gingerly climbed onto the bus did not bode well.
“There are no fractures, which is good, but my knee is very swollen,” he said. “I wasn’t able to push any power in the last few kilometres so I don’t know how I will be tomorrow.”
In a post on Twitter, Dumoulin said that he still had pain in his knee, but he was holding out hope that he could make it through stage 5. "Knee still hurts but we hope it will get better through the day. Will give everything I have to make it. Fingers crossed," he wrote.
While Dumoulin could try and recover before targeting stage wins, notably the two remaining time trials, he is also set to ride the Tour de France in July and, with the maglia rosa seemingly out of the question, he and his team may eventually decide to leave the Giro and re-focus instead of struggling on.
It will all depend on how Dumoulin fares on Wednesday’s stage 5. Mercifully, it’s the second shortest of the whole race, at 140 kilometres, with just one categorised climb on the net downhill route from Frascati to Terracina.
Knee still hurts but we hope it will get better through the day. Will give everything I have to make it. Fingers crossed https://t.co/uKBnkbGs4b— Tom Dumoulin (@tom_dumoulin) May 15, 2019